Healthcare Provider Details

I. General information

NPI: 1982970380
Provider Name (Legal Business Name): RONALD ROMERO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2012
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 CARPENTER RD
ANN ARBOR MI
48108-1108
US

IV. Provider business mailing address

3174 PACKARD ST
ANN ARBOR MI
48108-1947
US

V. Phone/Fax

Practice location:
  • Phone: 734-971-1073
  • Fax:
Mailing address:
  • Phone: 734-971-1073
  • Fax: 734-971-8545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301108115
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: